Health information exchanges cut costs, excess imaging
May 31, 2018
by Thomas Dworetzky, Contributing Reporter
Health information exchanges (HIE) reduced both the cost of healthcare and its use, according to a recent Indiana University report.
The findings are the opposite of an assessment three years ago.
The report found that overall HIE's led to fewer duplicated procedures, reduced imaging, lower costs and better patient safety.
"Up until this point, the promise of health information exchanges to improve care and reduce costs has been theoretical," reported lead author Nir Menachemi, a professor in the Indiana University Richard M. Fairbanks School of Public Health at IUPUI. "We now have reasonably strong evidence that there are benefits to using health information exchanges."
Menachemi was also the lead author of the three-year-old HIE review.
The latest report, published in the Journal of the American Medical Informatics Association, is a meta-analysis of 24 articles, including 63 health information exchange analyses, that appeared in the literature from May 2014 to June 2017. Overall, 68.3 percent reported a good impact from HIEs, while 7.9 percent experienced unanticipated ill effects. For the rest, HIEs had no impact.
In their review, the researchers also found that “studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges.”
One reason that the latest review had different findings, he advised, is that the exchanges are more mature and effective than they were in earlier generations.
"This finding bodes well for health information exchange's ability to deliver on anticipated improvements in the delivery of care," Menachemi said.
HIE systems are part of the growing global market for population health management solutions (PHM). The market is expected to hit $58.11 billion by 2023, up from 2018's $19.79 billion, according to an April report by ResearchAndMarkets.com, for a CAGR growth rate of 24 percent during that time period.
A surge in an aging population and the burden of chronic diseases, continued pressure to curtail rising healthcare costs, growing demand to improve care quality, implementation of the Affordable Care Act in the U.S., trends towards value-based care, growing digitization in emerging countries, increasing awareness about PHM, improving healthcare IT infrastructure and expanded adoption of EMRs and HIEs, are responsible, noted the report.
In addition, the robust demand has also been spurred by a greater focus on personalized medicine, along with more sophisticated IT solutions and the advent of big data use, combined with government support for more coordinated care and the advance of accountable care organizations (ACO), the study advised.
There are risks associated with the move into more use of such software, however.
“Patient data privacy and confidentiality issues, lack of data management capacities, and reluctance to migrate from conventional systems may hinder the growth of the global population health management solutions market to some extent,” the report also concluded.
An example of the type of step that gives a boost to further progress was highlighted during a May 29 Society for Imaging Informatics in Medicine webinar, moderated by SIIM Chair Paul Nagy, when a panel of contributors to the June issue of the Journal of Digital Imaging discussed the new tools available in imaging informatics.
Steve Langer, a professor of diagnostic physics and imaging informatics at the Mayo Clinic, spoke about how he and colleagues have developed a way to access data on multiple imaging devices for research purposes.
“Suppose you want to know what the state of a given patient exam is, or you want to find certain types of studies for a research protocol,” Langer said. “You would have to go from machine to machine to find it.”
To address this challenge, the team developed what Langer called a Standardized Operational Log of Events (SOLE), which lets machines export system logs in a standard format to a central server, making it easier to do clinical workflow data mining or research.
The findings are the opposite of an assessment three years ago.
The report found that overall HIE's led to fewer duplicated procedures, reduced imaging, lower costs and better patient safety.
"Up until this point, the promise of health information exchanges to improve care and reduce costs has been theoretical," reported lead author Nir Menachemi, a professor in the Indiana University Richard M. Fairbanks School of Public Health at IUPUI. "We now have reasonably strong evidence that there are benefits to using health information exchanges."
Menachemi was also the lead author of the three-year-old HIE review.
The latest report, published in the Journal of the American Medical Informatics Association, is a meta-analysis of 24 articles, including 63 health information exchange analyses, that appeared in the literature from May 2014 to June 2017. Overall, 68.3 percent reported a good impact from HIEs, while 7.9 percent experienced unanticipated ill effects. For the rest, HIEs had no impact.
In their review, the researchers also found that “studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges.”
One reason that the latest review had different findings, he advised, is that the exchanges are more mature and effective than they were in earlier generations.
"This finding bodes well for health information exchange's ability to deliver on anticipated improvements in the delivery of care," Menachemi said.
HIE systems are part of the growing global market for population health management solutions (PHM). The market is expected to hit $58.11 billion by 2023, up from 2018's $19.79 billion, according to an April report by ResearchAndMarkets.com, for a CAGR growth rate of 24 percent during that time period.
A surge in an aging population and the burden of chronic diseases, continued pressure to curtail rising healthcare costs, growing demand to improve care quality, implementation of the Affordable Care Act in the U.S., trends towards value-based care, growing digitization in emerging countries, increasing awareness about PHM, improving healthcare IT infrastructure and expanded adoption of EMRs and HIEs, are responsible, noted the report.
In addition, the robust demand has also been spurred by a greater focus on personalized medicine, along with more sophisticated IT solutions and the advent of big data use, combined with government support for more coordinated care and the advance of accountable care organizations (ACO), the study advised.
There are risks associated with the move into more use of such software, however.
“Patient data privacy and confidentiality issues, lack of data management capacities, and reluctance to migrate from conventional systems may hinder the growth of the global population health management solutions market to some extent,” the report also concluded.
An example of the type of step that gives a boost to further progress was highlighted during a May 29 Society for Imaging Informatics in Medicine webinar, moderated by SIIM Chair Paul Nagy, when a panel of contributors to the June issue of the Journal of Digital Imaging discussed the new tools available in imaging informatics.
Steve Langer, a professor of diagnostic physics and imaging informatics at the Mayo Clinic, spoke about how he and colleagues have developed a way to access data on multiple imaging devices for research purposes.
“Suppose you want to know what the state of a given patient exam is, or you want to find certain types of studies for a research protocol,” Langer said. “You would have to go from machine to machine to find it.”
To address this challenge, the team developed what Langer called a Standardized Operational Log of Events (SOLE), which lets machines export system logs in a standard format to a central server, making it easier to do clinical workflow data mining or research.